超声心动图评价糖尿病患者左心功能变化的可行性研究

Study on the feasibility of evaluating changes of left ventricular funetionin patients with diabetes mellitus heart disease by echocardiography

目的 探讨超声心动图在评价糖尿病（DM）患者左心功能变化的临床应用价值.方法 选择2010年1月～2011年4月诸暨市人民医院（以下简称“我院”）收治的无心脏病症状DM患者43例,按病程分为A组26例（发病＞2年）,B组17例（发病≤2年）;选择同期于我院行健康体检者30例（C组）.所有研究对象均行彩色多普勒超声心动图检测,观察并比较相关指标.结果 ①A组和B组患者左室舒张末期内径（LVIDd）[（57.9±4.2）、（47.5±3.7）mm]、室间隔舒张末期内径（IVSd）[（32.4±3.2）、（30.2±3.1）mm]、左室后壁舒张末期厚度（LVPWd） [（11.5±1.2）、（9.8±0.9）mm]及LVMI[（65.7±4.6）％、（67.5±4.9）％）]明显增加,与C组比较差异有统计学意义（P＜0.05）.A组患者左房前后径（LAd）[（39.2±3.2）mm]明显增高,与C组[（29.2±2.4）mm]比较,差异有统计学意义（P＜0.05）.A组LAd、LVIDd、IVSd、LVPWD及LVMI较B组明显增加,两组比较差异有统计学意义（P＜0.05）.②A组和B组患者Tei指数[（0.69±0.24）、（0.52±0.16）]明显增加,E/A[（0.78±0.32）、（0.83±0.35）]、Ea/Aa[（0.67±0.29）、（0.89±0.21）]明显降低,与C组比较差异有统计学意义（P＜0.05）.A组患者A[（75.3±8.9）cm/s]和Aa[（12.4±1.6） cm/s]明显增高,与C组[（67.9±5.4）、（8.9±2.1）cm/s]比较,差异有统计学意义（P＜0.05）.A组A、Aa及Tei指数较B组明显增加,E/A、Ea/Aa较B组明显降低,两组比较差异有统计学意义（P＜0.05）.结论 超声心动图检查可早期发现DM患者心脏解剖结构异常表现和对左心室舒张功能进行评估.

Objective To investigate the clinic value of echocardiograhy in diagnose the left ventricular function of diabetes mellitus （DM）.Methods 43 type 2 DM patients without evidences of heart diseases in People＇s Hospital of Zhuji City （＂our hospital＂ for short） from January 2010 to April 2011 were selected.43 type 2 DM patients without evidences of heart diseases were divided into group A with 26 cases （＞2 years） and group B with 17 cases （≤2 years） according to the course of the disease.30 health people in the same term were chosen as group C.All the research objects were examined by echocardiography,correlation indexes were observed and compared.Results ①LVIDd [（57.9±4.2）,（47.5±3.7） mm],IVSd [（32.4±3.2）,（30.2±3.1） mm],LVPWd [（11.5±1.2）,（9.8±0.9） mm] and LVMI [（65.7±4.6）％,（67.5±4.9）％] in group A and group B were higher than those in group C,the differences were statistically significant （P ＜ 0.05）.LAd in group A [（39.2±3.2） mm]was higher than that in group C [（29.2±2.4） mm],the differences were statistically significant （P ＜ 0.05）.LAd,LVIDd,IVSd,LVPWd and LVMI in group A were higher than those in group B,the differences were statistically significant （P ＜ 0.05）.②Tei index in group A and group B [（0.69±0.24）,（0.52±0.16）] was higher than that in group C,the differences were statistically significant （P ＜ 0.05）.E/A [（0.78±0.32）,（0.83±0.35）] and Ea/Aa [（0.67±0.29）,（0.89±0.21）] was lower than that in group C,the differences were statistically significant （P ＜ 0.05）.A [（75.3±8.9） cm/s],Aa [（12.4±1.6） cm/s] in group A was significantly higher than that in C group [（67.9±5.4）,（8.9±2.1） cm/s],the differences were statistically significant （P ＜ 0.05）.A,Aa and Tei index in group A was higher than that in group B （P ＜ 0.05） and E/A,Ea/Aa was lower than that in group B,the differences were statistically significant （P ＜ 0.05）.Conclusion Echocardiography can early detect cardiac changes and assess the left ventricular diastolic function.